Prostate brachytherapy after ileal pouch-anal anastomosis reconstruction.

Objective: To determine the safety of prostate brachytherapy in patients with clinically localized prostate cancer who have undergone proctocolectomy with ileal pouch-anal anastomosis (IPAA).

Methods: We performed a retrospective chart review of patients with a prior history of IPAA reconstruction who underwent prostate brachytherapy at our institution. Clinical records were reviewed for demographic characteristics, postoperative dosimetry, changes in bowel function, and oncologic outcomes. Data were analyzed using descriptive statistics.

Results: Five patients with an IPAA underwent prostate brachytherapy for clinically localized prostate cancer. Mean time from colorectal reconstruction to prostate brachytherapy was 6.3 years. Adequate dosimetry (mean D90 114.9%, mean V100 91.1%, mean R100 0.76 mL) was achieved in each patient. Bowel frequency worsened in the immediate postoperative period in all patients, but all patients returned to their baseline bowel pattern by 4 months after their procedure. Serious complications, such as J-pouch ulcers, fistulas, or fecal incontinence, did not occur in these patients.

Conclusions: Prostate brachytherapy is a safe treatment option in patients with clinically localized prostate cancer and a history of proctocolectomy and IPAA reconstruction.